How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $194.98 | Facility | None | $53.70 | $53.70 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $177.83 | Professional | None | $53.70 | $53.70 | $177.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $95.50 Median $117.49 Typical High $218.78 | Facility | None | $95.50 | $117.49 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $53.70 Typical High $128.82 | Professional | None | $48.98 | $53.70 | $128.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $36.31 Median $39.81 Typical High $53.70 | Professional | UE · Used equipment | $36.31 | $39.81 | $53.70 |
CareSource Setting Facility Modifier None Typical Low $56.23 Median $83.18 Typical High $112.20 | Facility | None | $56.23 | $83.18 | $112.20 |
CareSource Setting Professional Modifier None Typical Low $72.44 Median $100.00 Typical High $151.36 | Professional | None | $72.44 | $100.00 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | None | $46.77 | $46.77 | $64.57 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | None | $46.77 | $46.77 | $64.57 |
Molina Setting Professional Modifier None Typical Low $42.66 Median $58.88 Typical High $79.43 | Professional | None | $42.66 | $58.88 | $79.43 |
SummaCare Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $162.18 | Professional | None | $102.33 | $102.33 | $162.18 |
United Setting Facility Modifier None Typical Low $57.54 Median $60.26 Typical High $117.49 | Facility | None | $57.54 | $60.26 | $117.49 |
United Setting Professional Modifier None Typical Low $33.11 Median $47.86 Typical High $72.44 | Professional | None | $33.11 | $47.86 | $72.44 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $26.92 Typical High $89.13 | Professional | 52 · Reduced service | $26.92 | $26.92 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $35.48 | Professional | 53 · Discontinued | $10.72 | $10.72 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $26.92 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $17.78 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $17.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.25 Median $5.25 Typical High $5.62 | Professional | RR · Rental | $5.25 | $5.25 | $5.62 |
Where Ohio sits
The same service costs 3.5 times more in Hawaii than in New Jersey. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Ohio· 36th of 51
$53.70
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.